不同剂量阿托伐他汀对经皮冠状动脉介入治疗后主要不良心血管事件的影响

Influence of atorvastatin in different doses on major adverse cardiovascular events after percutaneous coronary intervention

目的探讨不同剂量阿托伐他汀对经皮冠状动脉介入(PCI)治疗后血脂和心血管事件的影响。方法选择2012年6月~2014年1月于延安大学咸阳医院心内科收治的不稳定型心绞痛(unstable angina,UA)患者120例。随机分为两组,40 mg组62例,其中男性32例,女性30例,平均年龄(52.10±10.55)岁;20 mg组58例,其中男性30例,女性28例,平均年龄(51.09±9.54)岁。分别于PCI治疗前给予阿托伐他汀20 mg和40 mg,PCI治疗后继续服用阿托伐他汀。比较两组患者治疗前、治疗后1个月、6个月总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)及高密度脂蛋白胆固醇(HDL-C)水平、主要不良心血管事件及不良反应的发生情况。结果与本组术前比较,两组PCI术后1个月、6个月TC、LDL-C、TG降低,差异有统计学意义(P均<0.05)。与20 mg组比较,40 mg组PCI术后6个月TC,术后1个月及6个月LDL-C、TG降低,差异有统计学意义(P均<0.05)。PCI后6个月内40 mg组主要不良心血管事件发生率为8.1%,20 mg组为13.8%,两组差异有统计学意义(P<0.05)。40 mg组出现肝功能异常2例,20 mg组1例,未出现横纹肌溶解等不良反应,两组不良反应发生率差异无统计学意义(P>0.05)。结论阿托伐他汀降低经皮冠状动脉介入术后患者血脂,但使用40 mg患者较20 mg术后主要不良心血管事件减少。

Objective To investigate the influence of atorvastatin in different doses on blood fat and major adverse cardiovascular events(MACE) after percutaneous coronary intervention(PCI). Methods The patients with unstable angina pectoris(UAP) were chosen(n=120) from Jun. 2012 to Jan. 2014, and randomly divided into 40-mg group(n=62, male 32, female 30 and average age=52.10±10.55) treated with 40 mg atorvastatin and 20-mg group(n=58, male 30, female 28 and average age=51.09±9.54) treated with 20 mg atorvastatin before PCI, and continuously given atorvastatin after PCI. The levels of TC, LDL-C, TG and HDL-C, and incidence of MACE and adverse reactions were compared in 2 groups before, 1 m and 6 m after treatment. Results The levels of TC, LDL-C and TG decreased in 2 groups 1 m and 6 m after PCI(all P<0.05). The level of TC decreased 6 m after PCI, and levels of LDL-C and TG decreased 1 m and 6 m after PCI in 40-mg group compared with 20-mg group(all P<0.05). The incidence of MACE was 8.1% in 40-mg group and 13.8% in 20-mg group within 6 m after PCI(P<0.05). There were 2 patients with abnormal liver function in 40-mg group and 1 in 20-mg group, and there was no case of rhabdomyolysis or other adverse reactions observed in 2 group(P>0.05). Conclusion Atorvastatin can reduce the level of blood fat in UAP patients after PCI, and the incidence of MACE decreases in patients with 40 mg atorvastatin than that in those with 20 mg atorvastatin.